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Scan50002 by T.Berry Brazelton, M.D. and Stanley I. Greenspan, M.D. (Da Capo Press, 2000)

We all wish that children engage in optimal performance at home, at school or with peers. Whenever there are problems though, one basic place to start the process of understanding the reasons for the problems is to ask the question:

“Are this child’s basic needs met?”

This book, written by two of the most reputable figures in the field, attempts to clarify this very issue.

They identify six “irreducible needs”.

1.       The Need for Ongoing Nurturing Relationships

2.       The Need for Physical Protection, Safety and Regulation

3.       The Need for Experiences Tailored to Individual Differences

4.       The Need for Developmentally Appropriate Experiences

5.       The Need for Limit Setting, Structure and Expectations

6.       The Need for Stable, Supportive Communities and Cultural Continuity

 

1. The Need for Ongoing Nurturing Relationships

“Supportive, warm, nurturing emotional interactions with infants and younger children help the central nervous system grow appropriately.”

“Listening to the human voice, engaging in interactive experiences, exchanging emotional gestures”   are examples of behaviors that foster attachment and relatedness.

The relationships help the child regulate their emotions and behaviors (“protect them from over- or understimulation”) and this way they can stay calm and alert for new learning.

 

2. The Need for Physical Protection, Safety and Regulation

Exposure to unnecessary risks, violence, early abuse and neglect, exposure to toxic substances undermine healthy development. Early exposure to chaotic environments, excessive use of TV and video games are other examples of toxic influence.

“… even modest damage to the functioning of the human central nervous system can result in an escalating cascade of learning, intellectual, emotional and social problems. For example, the children who are exposed to toxic substances (e.g., alcohol, tobacco, drugs, lead) in utero have a high likelihood of being born with nervous systems that are either over- or underreactive  to basic sensations such as touch and sound.”

Early exposure leads to a higher likelihood of problems with:

  • Auditory processing – understanding
  • Language in general – both self expression and understanding
  • Visual-spatial thinking – form of thinking that does not rely on words but on images,  often has to do with emotional thinking and creativity
  • Motor planning and sequencing – planning and carrying out actions (executive skills)

“Any one of these factors can increase the tendency toward learning problems, impulsivity, antisocial behavior, difficulties with forming peer relationships, reading social cues, and even organizing thinking and sustaining a sense of reality.”

The authors assert that the natural therapeutic approach is to offer “corrective environmental experiences“.  This is a balance of:

a) sustained nurturance, compassion and empathy

b) persistent gentle, but firm limits

c) persistent work on planning, organizing behavior, anticipating consequences of actions  (modulating activity or external regulation)

d) persistent work on reflecting on feelings – one early example may be pretend play.

Like in other situation, none of these ingredients, if provided alone is sufficient, but a flexible and thoughtful combination is recommended.

 

3. The Need for Experiences Tailored to Individual Differences

We are all different even if in some aspects we are all the same. Some way or another we need to adapt and adjust not only to the fact that all babies and all children and all adolescents have common needs but also to the fact that there are individual differences.

Ignoring individual differences or maintaining a double standard leads to unproductive educational strategies with potentially damaging consequences. Examples of what I referred as “double standard” would be “I know John is hyper but he should learn to sit still at the dinner table” or “I know Jane is not good at reading but she needs to do her reading or will be grounded.”

Have you ever been there as a parent? It takes ongoing effort to escape this powerful tendency to ask people to deliver on what they have the least. If the child is hyperactive the apparently desirable trait would be to “sit still” so we find ourselves “working on it”. Relentless pressure to “have the opposite behavior”, no matter how well indented, is of limited effectiveness both on behavioral change and on having a positive developmental course. Not to speak about the damaging effect on the relationship.

Of course, we want undesired behaviors to be replaced by adaptive ones. But simply wanting it and pressing for it is not the answer. Without taking in consideration and respecting the child’s individual differences, I may be able to change a behavior while “losing the child”.

 

4. The Need for Developmentally Appropriate Experiences

Dr. Greenspan published several books presenting powerful arguments for his way of understanding different developmental stages. They are also briefly described in the summary of another book, “The Challenging Child”.  Essentially, this basic need of children reflects the belief that the caregivers need to provide certain specific ingredients in their care depending on the child’s developmental stage.

Ability to focus and attend calmly

  • Being “calm and regulated and at the same time attentive to an exciting world.”
  • Requires from caregivers: security, soothing, external regulation (e.g. adjusting the stimulation).

Ability to Feel Warm and Close to Others

  • Being “warm trusting and intimate both with adults and peers.”
  • Requires from caregivers: nurturance, empathy, compassion.

Ability for intentional two-way communication without words

  • Being able to read and produce adequate “nonverbal cues” in communication with others.
  • Requires from caregivers: extensive engaging in communication with the child with patience, empathy, excitement.

Capacity to solve problems and forming a sense of self

  • Being able to recognize patterns and use them for problem solving; developing an early sense of self.
  • Requires from caregivers: to actively engage in communication, show admiration, to encourage.

Emotional Ideas

  • Being able to use “an idea, expressed in words, to communicate something about what they want, what they feel, or what they are going to do.” (“I am happy”)
  • Requires from caregivers: engage in communication and external regulation (help the child manage their own emotions).

Emotional Thinking

  • Being able to comment about behaviors and connect these comments with different categories of ideas and feelings (“I am happy because Mommy was nice”).
  • Requires from caregivers: engage in communication and external regulation (help the child manage their own emotions).

 

5. The Need for Limit Setting, Structure and Expectations

Very few people, even these days, doubt the importance of discipline, structure and respect in child rearing. The ideas about how to get there vary. Some parents tend to have a very firm, disciplinarian approach while other parents prefer for the children to internalize a sense of “why” or understanding about the propriety of the behavior. Others, just wish “respect” to be present “because I’m the parent”.

Limit setting, structure and expectations are not important because “people say”, or because would bring peace to my household but they are crucial to child’s development. Babies have all their needs met by their caring mothers and this becomes the experience of fulfillment or “good”. Sometimes the care comes after a delay and for a little while the baby will experience loss or “bad”.

As the child matures, will be able to tolerate the frustration of not getting what is desired right away. Actually will have to learn to postpone satisfaction longer and longer. Moreover, at some point the parent starts to have demands on the child not just the child on the parent. More frustration to tolerate.

The child needs to transition from a stage where the only thing that matters is her own subjective satisfaction to a stage where she needs to realize that she lives in a world with other people, also having their own needs and wants and they will have to take turns.

This transition may not successful without the parent providing expectations, limit setting and structure. The child may be stuck, carrying at age 8 or even later, fantasies that all wants need to be fulfilled and swing into righteous anger when this fails to happen.

Structure and expectations help us understanding (eventually) that the world is neither good nor bad but there is good and bad in it, both satisfaction and postponement, both fun and work.

But in order to be effective, limit setting needs to begin “with nurturing care, from which children learn trust, warmth, intimacy, empathy, and attachment to those around them”. In the parent-child relationship this warm trust needs to precede limit setting and structure in order for the latter to be effective.

Furthermore, when I am setting limits I constantly need to move back and forth between “structure” and “warm connection”. One useful simplification may be like this. Asking for something is “spending influence” and nurturing is “gaining influence”. When I am asking the child to do “the hard thing” I spend “money” from my account. If I keep doing this the account will drop to zero and I cannot buy anything. It is preferable that before I get to zero I do some “connection work” to get something in my account.

I found that many parents may struggle with this flexibility or turn taking. Once we realize that we need to emphasize structure and limit setting we cannot ignore the first need for “ongoing nurturing relationships”.

 

6. The Need for Stable, Supportive Communities and Cultural Continuity

“Communities and cultures provide the context or framework for the other irreducible needs that we have discussed. It’s easy to overlook this vital component.”

This chapter addresses many aspects of our, often, very diverse communities and the impact that they have on child development.

  • Is the community stable and self-sufficient?
  • Is there a sense of identity in the community?
  • Is the community involved in overseeing the public education?
  • Are the children developing with a sense of continuity of culture and history?
  • Are the children developing capable to integrate the diversity in the larger community within the family background?

 

 

 

 

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